Kwan Soo Chen
Position:Program specific postdoctoral researcher
MAIL: sc.kwan [at] cseas.kyoto-u.ac.jp
・A Systematic Review on The Effects of Active Commuting on Cardiovascular Health
・Geospatial-Temporal Analysis of the Causal Linkages between Built Environment
and Non-communicable Diseases towards Urban Sustainability
・Urban environment and cause specific visits to community health centres in Medan city, Indonesia
A Systematic Review on The Effects of Active Commuting on Cardiovascular Health
Previous systematic reviews on the association between active commuting and health have often indicated a lack of robustness in the evidence due to poor quality studies (Shaw et al., 2014; Saunders et al., 2013). Most studies were cross sectional in design which has low confidence in inferring the causative relationship. In addition, meta-analysis of studies was difficult to implement because of the high heterogeneity in the indicators used to measure cardiovascular health outcomes in each studies. A recent study pointed out the limitations of previous systematic review on the effects of active commuting on cardiovascular health (Hamer and Chida, 2008), that it did not distinguish between the types of active commuting (walking and cycling), and the types of cardiovascular health outcomes in its analysis, in addition to a lack of consistent adjustment for confounders between studies (Celis-Morales et al., 2017). Besides, the evidence on the effect of cycling on the mortality and morbidity of coronary heart disease were still inconclusive as indicated by other reviews (Saunders et al., 2013; Oja et al., 2011). However, in the recent years, a number of new studies have emerged both in the scholarly and the government institutions, as active commuting becomes more popularized. Therefore, this systematic review aims to compile these studies and produce pool estimates of the effects of active commuting on cardiovascular health directly or indirectly through its risk factors.
Geospatial-Temporal Analysis of the Causal Linkages between Built Environment
and Non-communicable Diseases towards Urban Sustainability
Health has often been neglected in the process of formulations of policies that are seemingly unrelated. This project attempts to incorporate the concept of Health in All Policies (HiAP), particularly in the field of urban planning and spatial development. In the developing countries where many cities have started to emerge, it is important that health becomes one of the core considerations in the local governance. This study will provide explicit evidence to inform the stakeholders of developing countries on the causal effect of built environment on non-communicable diseases, which top the global health concern currently. Besides, most of the previous studies on this topic have been based in developed countries such as Europe, U.S. and Australia, and could only produce the associative relationships between the variables. As the culturally rich Asian region where many developing countries are rising rapidly have been adopting the results of these research, it is important that these countries have their own local studies for better decision making in the local context. In addition, health co-benefits have been widely promoted as a win-win strategy for sustainable development to leverage use of resources in developing countries. Such strategy also encourages co-operation between sectors to reduce duplicate efforts and save on resources in achieving common goals.
Urban environment and cause specific visits to community health centres in Medan city, Indonesia
This study aims to analyse the relationship between urban built environment and population health in Medan city, Indonesia. This is an ecological study using secondary aggregated data in 2016 at the level of local community health centres in Medan. We included four transport infrastructures or services, and five land use metrics as the independent factors for the number of visits for mental disorders, hypertension, diabetes type 2, and all cause mortality. All the parameter measurements were estimated according to the boundaries of villages covered under each health centre. We used quasi-Poisson regression model to analyse the count data. The model revealed that the total visits for mental disorders significantly increased with density of rails (RR 2.16, 95% CI 1.19, 3.92), roads (RR 1.20, 95% CI 1.04, 1.39), open spaces (RR 1.27, 95% CI 1.07, 1.50), and educational institutes (RR 1.10, 95% CI 1.05, 1.16) in the area. Rail density also increased the visits for hypertension (RR 2.44, 95% CI 1.15, 5.16). On the other hand, we found that increased road intersections marginally decreased the visits for mixed anxiety and depressive disorders (MADD) (RR 0.99, 95% CI 0.98, 1.00) and diabetes (RR 0.99, 95% CI 0.99, 1.00). Medan city needs more health conducive infrastructure development to facilitate the effects of built environment as an intervention on population health. Further studies including individual level factors are needed to understand the actual health implications of built environment in Medan city.
- 1. SC Kwan, R Sutan, JH Hashim. Trip characteristics and intention to shift to rail transport among private motor vehicle users in Kuala Lumpur, Malaysia. Sustainable Cities and Society, 36 (2018), 319-326.
- 2. SC Kwan, M Tainio, J Woodcock, R Sutan, JH Hashim. The carbon savings and health co-benefits from the introduction of mass rapid transit system in Greater Kuala Lumpur, Malaysia. Journal of Transport and Health, 6 (2017), 187-200.
- 3. SC Kwan, JH Hashim. A review on co-benefits of mass public transportation in climate change mitigation. Sustainable Cities and Society, 22 (2016), 11-18.
- 4. SC Kwan, M Tainio, J Woodcock, JH Hashim. Health co-benefits in mortality avoidance from implementation of the mass rapid transit (MRT) system in Kuala Lumpur, Malaysia. Reviews on Environmental Health 2016, 31(1), 179-183.